Iodine-123 diagnostic dose, 100-999 microcuries at Samaritan Hospital

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) CAPSULE

Troy, NY

See all hospitals reporting HCPCS A9516 →

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Pricing by billing methodology

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How this price compares nationally

Samaritan Hospital’s median price of $154 is 14% below the median hospital's median price ($178), higher than 42% of the 1,910 hospitals reporting HCPCS A9516. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9516 at Samaritan Hospital

Negotiated rates from the hospital’s own file: 14 payers, 22 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	UnitedHealthcare uhc essential plan medicaid facility · percent of total billed charges · bothfrom % of charges	$99	$102	$7	7%	—	$96 – $112
2	UnitedHealthcare united healthcare medicaid harp chip facility · percent of total billed charges · bothfrom % of charges	$99	$102	$7	7%	—	$96 – $112
3	Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	—	$132 – $154
4	Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	—	$132 – $154
5	Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	—	$132 – $154
6	Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	—	$132 – $154
7	Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	—	$132 – $154
8	Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	—	$132 – $154
9	Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	—	$132 – $154
10	Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	1–10	$132 – $154
11	Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	—	$132 – $154
12	Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	—	$132 – $154
13	Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	—	$132 – $154
14	Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$136	$141	$9	7%	—	$132 – $154
15	Aetna aetna facility · percent of total billed charges · bothfrom % of charges	$173	$179	$12	7%	1–10	$169 – $196
16	Medical Mutual aetna facility · percent of total billed charges · bothfrom % of charges	$173	$179	$12	7%	—	$169 – $196
17	First Health first health facility · percent of total billed charges · bothfrom % of charges	$198	$205	$14	7%	—	$193 – $224
18	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$210	$218	$14	7%	—	$205 – $238
19	MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges	$223	$230	$15	7%	—	$217 – $252
20	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$223	$230	$15	7%	—	$217 – $252
21	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$223	$230	$15	7%	—	$217 – $252
22	UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges	$248	$256	$17	7%	—	$241 – $280

Last updated: Mar 31, 2026

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